This review aims to create an evidence-based resource for DME that a practitioner can use in their clinical work. Additionally, this systematic review will examine all the DME-related issues and debates. An electronic literature search was performed by two different reviewers up to July 2022 using MEDLINE through PubMed, Web of Science, SCOPUS, and EMBASE. We only considered in-vitro research that examined the impact of Deep Margin Elevation Material on fracture resistance. Software (Review Manager v5.4.1; The Cochrane Collaboration, Copenhagen, Denmark) was used to conduct a meta-analysis. Each study's bias risk was evaluated using another systematic review's criteria. From all databases, 517 pertinent papers were selected. Twenty-two publications were left after the title and abstract evaluation for qualitative analysis. Five studies were left after these for the meta-analysis. With composite restorations, the fracture strength of teeth undergoing deep margin elevation was statistically higher than the control (p = 0.04). Most analyses revealed significant heterogenicity. The in vitro evidence indicates that, compared to teeth restored directly with indirect restorations without the DME technique, the deep margin elevation procedure tended to improve the teeth' fracture resistance.
